Lip Incompetence

Q: Dr. Eppley, My son is 18 years old and very uncomfortable with the openness of his lips while at rest. (lip incompetence) It is affecting his day to day life and I’m desperately trying to find a solution for him. We have seen two oral surgeons who would not recommend jaw surgery, but would do it we decided that was the only route. We don’t want to take that route! He has a short upper lip and a long upper jaw. In addition, he is on his third round of orthodontics. He needs some hope and frankly so do I. We will travel to see you if you think it is worthwhile.

A: Thank you for your inquiry. Your son has vertical maxillary excess which is the source of his excessive tooth show, apparent short upper lip and long, unrotated lower jaw and lip incompetence. I see no recourse but for him to undergo a maxillary impaction procedure (LeFort I shortening) probably combined with an osteotomy of his mandible (to get his bite to fit again) and a sliding genioplasty advancement. It is a big decision but the only one that will work for him in the long run.

Dr. Barry Eppley
Indianapolis, Indiana